Diagnostic accuracy of examination tests for lateral elbow tendinopathy (LET) – A systematic review

Karanasios, Stefanos; Korakakis, Vasileios; Moutzouri, Maria; Drakonaki, Eleni E.; Koci, Klaudia; Pantazopoulou, Vasiliki; Tsepis, Εlias; Gioftsos, George

doi:10.1016/j.jht.2021.02.002

Cited by 35 publications

(29 citation statements)

References 66 publications

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“…Our investigation should be interpreted in the light of its limitations. The increased symptom duration and heterogeneity in diagnostic criteria is a possible confounder factor of outcomes and treatment success, 68 especially in the case of a passive treatment technique like extracorporeal shockwave therapy. However, a subgroup analysis for the latter factor was not possible.…”

Section: Discussionmentioning

confidence: 99%

Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and meta-analysis

et al. 2021

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Objective: To evaluate the effectiveness of extracorporeal shockwave therapy compared with other interventions on pain, grip strength and disability in patients with lateral elbow tendinopathy. Data Sources: MEDLINE, PubMed, CINAHL, EMBASE, PEDro, ScienceDirect, Cochrane Library and clinical trial registries. Review methods: We included randomized controlled trials assessing the effectiveness of extracorporeal shockwave therapy alone or as an additive intervention compared with sham or other interventions. Pain intensity, grip strength and elbow disability were used as primary outcome measures. We assessed methodological quality with the PEDro score and quality of evidence with the GRADE approach. Results: Twenty-seven studies with 1871 patients were finally included. Extracorporeal shockwave therapy reduced pain intensity at mid-term follow-up (standardized mean difference: −1.21, 95% confidence interval:−1.53, −0.89, P < 0.001) and improved grip strength at very short- (mean difference:3.92, 95% confidence interval: 0.91, 6.94, P = 0.01) and short-term follow-up (mean difference:4.87, 95% confidence interval:2.24, 7.50, P < 0.001) compared with sham treatment. However, no clinically significant results were found between comparators in all outcomes and follow-up times. Extracorporeal shockwave therapy presented clinically better compared to Laser in grip strength at short-term (mean difference:3.50, 95% confidence interval:2.40, 4.60, P < 0.001) and ultrasound in pain intensity at very-short-term follow-up (standardized mean difference: −1.54, 95% confidence interval: −2.60, −0.48, P = 0.005). Conclusion: Low to moderate certainty of evidence suggests that there are no clinical benefits of extracorporeal shockwave therapy compared to sham interventions or corticosteroid injections. Based on very-low and moderate certainty of evidence, extracorporeal shockwave therapy outperforms against Laser and ultrasound, respectively. Level of Evidence: Therapy, level 1a.

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Section: Discussionmentioning

confidence: 99%

Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and meta-analysis

et al. 2021

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“…Ultrasonography and magnetic resonance imaging have variable sensitivity and specificity, and are not routinely required. 1 3 Symptoms of tennis elbow are managed with physiotherapy and anti-inflammatory agents Eccentric strengthening of the common extensor origin (Appendix 1, avail able at www.cmaj.ca/lookup/doi/10.1503/cmaj.211047/tabrelated content) reduces pain and improves function and grip strength. 2 Topical nonsteroidal antiinflammatory drugs (NSAIDs) reduce pain (number needed to treat = 7) with few adverse effects, but oral NSAIDs provide unclear benefit with a risk of gastrointestinal adverse effects.…”

Section: The Diagnosis Is Clinical Based On Lateral Elbow Pain and Ep...mentioning

confidence: 99%

Lateral epicondylosis

Liu

Badre

2022

CMAJ

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“…La prévalence de l’épicondylite latérale représente 1 %–3 % de la population, culminant à l’âge de 35–50 ans 1 . On l’associe au tabagisme et à une combinaison d’activités manuelles répétitives et énergiques 2 .…”

Section: L’épicondylite Latérale (Ou Tennis Elbow) Est Un Problème De...unclassified

Épicondylite latérale

Liu

Badre

2022

CMAJ

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Diagnostic accuracy of examination tests for lateral elbow tendinopathy (LET) – A systematic review

Cited by 35 publications

References 66 publications

Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and meta-analysis

Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and meta-analysis

Lateral epicondylosis

Épicondylite latérale

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